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Thursday, March 16, 2017 12:05 am

Get fit with intensity

No matter your age, high intensity is good for you

Rowing with high intensity can be more enjoyable than a long slow row.


As an orthopedic surgeon specializing in sports medicine, including prevention and treatment of athletic injuries, I see a lot of athletes and active individuals of all ages. My goal is to keep people as active as possible and to maximize performance while minimizing injury potential. Exercise is the cheapest form of health insurance, and starting and maintaining a regular exercise program is the key to longevity. A well-rounded physical activity program has often been said to include aerobic exercise, strength training and flexibility sessions. But what is often overlooked is the importance of adding intensity and the need to challenge the body’s neurocircuitry.

Adding high intensity workouts will boost your overall health, and it can be done safely. As a longtime runner and triathlete, I can say that since I have added CrossFit to my routine, I am now in the best overall shape that I have been since my collegiate athletics days. I am glad that I did not let my initial fear of the unknown hold me back. I continue to seek information and have completed my Level I CrossFit certification. It is my hope that this article will allay some fears about high intensity workouts and motivate you to step outside your comfort zone.

Athletes and coaches have long known about the benefits of high intensity interval training (HIIT*) – alternating periods of short, intense exercise with less intense recovery periods. The concept may seem simple. Less total time is required to make a big change and you get more bang for your buck. It is also important to note that high intensity need not mean high impact. A HIIT program can be customized for any age. The perks extend far beyond saving time. Benefits include gains in aerobic and anaerobic fitness, decreased blood pressure, improved insulin sensitivity (which helps the body more readily use glucose for fuel to make energy), improved cholesterol profiles and, of course, decreased abdominal fat and body weight and increased muscle mass.

HIIT workouts provide similar fitness benefits as continuous endurance programs in a much shorter period of time. This is because HIIT programs increase the caloric expenditure, especially after the workout. This post-exercise effect is called “EPOC,” which stands for Excess Post-exercise Oxygen Consumption. After exercise, there is a period of two or more hours where the body restores itself to pre-exercise levels or to homeostasis, and is thus using more energy (the post-exercise “burn” or “caloric fire”). Because of the greater vigorous muscle contractile efforts during HIIT workouts, the EPOC is often greater and may add 15 percent or more to the overall workout energy expenditure. You can get the same, if not greater, results in half the time doing high-intensity intervals compared to low-intensity longer duration workout sessions. A 2013 study in the Journal of Physiology found that sedentary men who did 40 to 60 minutes of cycling at 65 percent of their max heart rate five times a week and those who did sprint interval training for less than 12 minutes three times a week saw similar results, including increased insulin sensitivity.

HIIT workouts are often more enjoyable than longer steady state exercise due to variety. Running, biking, jumping rope and rowing all work well for HIIT, but special equipment is not necessary, and in fact CrossFit emphasizes “functional movement.” Calisthenic moves, high knees, lunges, weights, body weight exercises and other moves can be incorporated. A study in the Journal of Strength and Conditioning Research found that people who did cycling intervals and people who did intervals of calisthenic moves like burpees saw similar results in terms of VO2 max and heart rate.

What about the risk of injury? Any sports activity carries injury risk. Even couch potatoes can get injured – though their stories are less interesting. Runners actually have the highest overall rate of sport injury with 80 percent having some injury in their lifetime, usually due to overuse. Potential for injury with cross training is decreased. Injury in HIIT is minimized when the novice exerciser entering a HIIT program, after first seeking medical evaluation and clearance, uses a slow progression including buildup of core strength, balance and conditioning. It is important to access the expertise of a certified trainer or coach to assist with creating the proper exercise prescription.

Education, attention to proper form and common sense is critical for preventing injury. HIIT can be easily modified for people of all ages, for various fitness levels, and for those with special conditions such as obesity or osteoarthritis. Again, increasing intensity and heart rate does not have to equate with increased impact. With education and a good trainer, CrossFit and other HIIT programs are scalable so that anyone can do the workouts. Injuries tend to happen when proper form is neglected, and when the participant loses sight of the goal of internal competition with oneself and instead focuses on others. Proper technique is the key to injury prevention.

Adding even small increments of high intensity can produce not only physical but mental benefits. Research has shown that just one minute of high-intensity work added to an otherwise moderate workout can boost mitochondria, which help fuel your body and brain. HIIT also stimulates production of human growth hormone (HGH) by up to 450 percent during the 24 hours after workout. HGH not only increases caloric burn but also slows down the aging process. So exercise does seem to be the fountain of youth, keeping you younger inside and out!

In exercise and in life, if we continue to do what we have always done, we will get the results we have always achieved. If you desire improvement, get comfortable with being uncomfortable! Challenge yourself to reap the benefits of a CrossFit or other HIIT regimen.

Diane Hillard-Sembell, M.D. is a sports medicine physician and knee orthopedic surgeon at Springfield Clinic.

Also from Diane Hillard-Sembell, M.D.

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